It’s hard to listen to the news or read a paper where we don’t hear about the obesity epidemic all across America. It is estimated that 69% of all U.S. adults are overweight and about 35% are obese (they have a BMI above 30) We all know the risk factors with obesity. How do these individuals fare when it comes to plastic surgery? Obesity (BMI above 30) was associated with an increased risk of heart attack, wound infection and urinary tract infections. People who are morbidly obese (BMI above 40) have an increased risk of mortality. But how do these obese and morbidly obese patients do with elective cosmetic procedures? A recent study of over 127,000 patients found that 36.2% were overweight (BMI above 25) . Complication rates rose as BMI increased. BMI above 30 had a complication rate of 1.4% while a BMI above 40 saw a complication rate of 4.2%. Wound infections were more common and pulmonary dysfunction or venous thrombosis were more common. Risk of a hematoma was about the same. So obesity does matter.